Provider Demographics
NPI:1336622968
Name:UPHOLD, ALLISON ELAINE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ELAINE
Last Name:UPHOLD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12720 DAYBREAK CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-9531
Mailing Address - Country:US
Mailing Address - Phone:240-367-4473
Mailing Address - Fax:
Practice Address - Street 1:100 ANNA GOODE WAY
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-9236
Practice Address - Country:US
Practice Address - Phone:757-623-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043495225100000X
MA24208225100000X
PAPT027688225100000X
GAPT013973225100000X
VA2305212670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist